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下肢深静脉血栓形成时肌肉间隙的跨毛细血管压力

Transcapillary forces in muscle compartments of lower limbs with deep venous thrombosis.

作者信息

Seem E, Stranden E

机构信息

Department of Vascular Surgery, Aker Hospital, Oslo, Norway.

出版信息

Scand J Clin Lab Invest. 1990 May;50(3):325-30. doi: 10.3109/00365519009091586.

Abstract

Interstitial fluid pressure (Pif), plasma- and interstitial fluid colloid osmotic pressures (COPpl, COPif) were measured in muscle compartments of the calf in lower limbs of patients with deep venous thrombosis (DVT) and in contralateral limbs. Pif was measured with the 'wick-in-needle' technique in the anterior and deep posterior compartments in three periods of time following start of treatment for DVT. The first period was from 0-24 h, the second from 24-48 h and the third later than 48 h. We found a significant increase in both muscular compartments in legs with DVT compared to the contralateral in the three periods except for Pif in the anterior compartment in the third period. A significant reduction of Pif in both muscular compartments of limbs with DVT was found when comparing the first and second periods but not from the second to the third period. No difference was found in Pif in the muscular compartments of the contralateral limbs between the three periods. Interstitial fluid for COPif measurements was obtained by inserting intravenous cannulas in the deep posterior muscle compartment of the calf of limbs with DVT and contralateral limbs. In oedematous tissue it was possible to collect some fluid, but this was almost impossible in the non-oedematous tissues of the contralateral limbs. COPif was 4.2(2.4) mmHg (mean(SD)) in the deep posterior compartment of limbs with DVT, which is probably significantly reduced. Increased Pif and reduced COPif indicate increased transcapillary fluid filtration and reduced reabsorption as the main cause of oedema in muscular compartments in DVT of the lower limbs.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在深静脉血栓形成(DVT)患者的下肢小腿肌肉间隙以及对侧肢体中,测量了组织间液压力(Pif)、血浆和组织间液胶体渗透压(COPpl、COPif)。采用“针芯吸液”技术,在DVT治疗开始后的三个时间段,测量了前侧和后侧深部肌肉间隙的Pif。第一个时间段为0 - 24小时,第二个时间段为24 - 48小时,第三个时间段为48小时以后。我们发现,与对侧相比,DVT患者腿部的两个肌肉间隙在这三个时间段内均有显著增加,但第三个时间段前侧间隙的Pif除外。比较第一和第二个时间段时,发现DVT患者肢体的两个肌肉间隙的Pif显著降低,但从第二个时间段到第三个时间段则没有。三个时间段内对侧肢体肌肉间隙的Pif没有差异。通过在DVT患者肢体和对侧肢体小腿后侧深部肌肉间隙插入静脉套管来获取用于测量COPif的组织间液。在水肿组织中可以收集到一些液体,但在对侧肢体的非水肿组织中几乎不可能。DVT患者肢体后侧深部间隙的COPif为4.2(2.4) mmHg(均值(标准差)),可能显著降低。Pif升高和COPif降低表明跨毛细血管液体滤过增加和重吸收减少是下肢DVT患者肌肉间隙水肿的主要原因。(摘要截选至250字)

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